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When the “crab” knocks at your door

Around 400 B.C., Hippocrates is said to have named masses of cancerous cells karkinos — Greek for crab. Why did he use that word?

A malignant tumour is usually hard mass, so maybe it reminded him of the hard shell of a crab. Others have said it may have reminded him that the pain that a malignant tumour sometimes induces is much like the sharp pinch of a crab’s claw.

An even better version is that it suggests the tenacity with which a crab bites and refuses to let go reminding Hippocrates and other doctors how stubborn these things were to remove.

About 47 A.D., the Greco-Roman philosopher Celsus, who wrote a very important encyclopedia of medicine even if he was not a medical doctor, named it cancer, the Latin equivalent of crab. The word has remained to this day.

About 100 years later, another very famous doctor named Galen extended even further the Hippocratic metaphor as, when dissecting a breast tumour, he noticed all the veins and tributaries of malignancy around the mass and said it looked just like a crab’s legs extending outward from every part of its body. So the term really stuck … even though doctors, for many hundreds of years, did not really know what caused it.

Dealing with emotions

It is natural to feel lost with a cancer diagnosis, it is normal to feel frightened, sad and worried… Dealing with emotions may not be easy at first.

Being given a cancer diagnosis brings many changes in life for the individual, family and friends. Simply having answers to the questions that arise will help the person to feel more in control and less worried about what lies ahead.

The thought of living with cancer, the heavy treatment ahead and the fear of dying can be overwhelming.

Managing emotions, regaining a sense of control and learning there is always hope are an important part of dealing with this diagnosis.

There is a busy time ahead, facing decisions about treatment, organising daily life for all possible events, trying not to lose control and, more importantly, keeping hopes high when considering the future.

Feeling strong and positive will help during the healing process. However, mood swings can be common, and sadness, worry and fear are natural emotions during the cancer journey.

Working through emotions can help lower stress and lead to improved mental and physical health.

Having a “personal support system” is an important part of dealing with emotions. It is also important to have a supportive healthcare team, during and after treatment.

Dealing with other people’s emotions

Dealing with other people’s emotions and beliefs about cancer can also be challenging. Those closest to the one that was taken ill might worry about losing them and be concerned about how the changes in their life might affect them. It can be hard for a person to deal with the fears of others while facing their own.

Sometimes people, even as they try to offer support, are not sure what to say and some might say or do things that hurt the patient’s feelings. Some people feel uncomfortable when thinking about the possibility of cancer in their own lives and, because of their own fears, may not know the best way to help others with their illness.

People can also pass on incorrect information, false beliefs and myths about cancer. For example, although we do not yet know what causes most types of cancers, people might try to find a reason for the cancer. They might even give their opinion about the best cure for cancer. The patient must tell them that, although their concern is appreciated, they are not helping.

Any medical advice must come from the healthcare team responsible for the patient.

Cancer is not just one disease

There are many types of cancer. It can start in different places in the body like lungs, breast, colon, or even in the blood. Cancers are alike in some ways, but they can be different in the ways they grow and spread.

Normal cells in our bodies all have their own jobs to do and when they are worn out or damaged, they are replaced with new cells, through the division of the characteristic cells of each part of the body, in a certain specific way that guaranties that the new ones are exactly like the old ones.

Cancer cells are new cells that are not normal. These cells keep on growing out of control, making more and more abnormal new cells. These cells crowd out normal cells causing obvious problems in the part of the body where the cancer has started.

Cancer cells can also spread to other parts of the body – like cancer cells in the lung that can travel to the bones and grow there. This is called metastasis, but it is still lung cancer, even if these cells are in the bones, as cancers are named for where they start, not where they end up.

Some types of cancer grow and spread very quickly whilst others grow more slowly. They also need different treatment approaches. Some are best treated with surgery, others respond better to drugs and others to radiation treatment. Two or more different treatments are often used to get the best possible results. Treatment is aimed at each type of cancer, to destroy the abnormal cancer cells.

Accepting reality

Most people need some time to adjust to the fact that they have cancer. They need time to think and adjust to the impact in their lives, accept reality and get support.

It is an emotionally hard time where feelings such as disbelief, shock, fear and anger are expected and use up a lot of mental energy, making it even harder to take in that it is not a bad dream, it is real and it is important to understand and accept all the medical information.

It is important to learn as much as possible about the type of cancer that was diagnosed and its treatment, as learning about their cancer and its treatment gives a sense of control over what is happening.

People cope with cancer in many different ways, like with other problems in life.

It is also important to focus on what can be controlled, not on what cannot.

It is a fight that the patient must want to win using all available “weapons”.

The advances in cancer treatment are impressive, with new “weapons” being discovered, being tested and becoming available.

With these new approaches, it has been possible to convert some metastatic cancer patients, with weeks to live, into chronic disease patients living a better quality of life.

Hope and science are driving fast and steady to beat the “crab” and win the game of life.

Best health wishes,
Dr. Maria Alice

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Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service / Medilagos. Medical Director – Grupo Hospital Particular do Algarve